Intraoperative DBS targeting of the globus pallidus internus by using motor 
evoked potentials

Trenado, Carlos; Nikolov, Petyo; Slotty, Philipp J.; Vesper, Jan; Schnitzler, Alfons; Groiss, Stefan Jun

doi:10.1016/j.jns.2024.123141

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Intraoperative DBS targeting of the globus pallidus internus by using motor evoked potentials

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Trenado, Carlos
Department of Music, Max Planck Institute for Empirical Aesthetics, Max Planck Society;
Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University;

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Citation

Trenado, C., Nikolov, P., Slotty, P. J., Vesper, J., Schnitzler, A., & Groiss, S. J. (2024). Intraoperative DBS targeting of the globus pallidus internus by using motor evoked potentials. Journal of the Neurological Sciences, 463: 123141. doi:10.1016/j.jns.2024.123141.

Cite as: https://hdl.handle.net/21.11116/0000-000F-E9AB-A

Abstract

Objectives
Target localization for deep brain stimulation (DBS) is a crucial step that influences the clinical benefit of the DBS procedure together with the reduction of side effects. In this work, we address the feasibility of DBS target localization in the globus pallidus internus (GPi) aided by intraoperative motor evoked potentials (MEP) with emphasis on the reduction of capsular side effects.
Material and methods
Micro-macroelectrode recordings were performed intraoperatively on 20 patients that underwent DBS treatment of the GPi (GPi-DBS). MEP were elicited intraoperatively by microelectrode stimulation during stereotactic DBS surgery. We studied the relationship between MEP thresholds and the internal capsule (IC) proximity.
Results
We found a significant correlation between intraoperative MEP thresholds and IC proximity.
Conclusions
We provide further evidence of the role of MEPs for DBS target localization in the GPi, which extends and confirms the usefulness of MEPs as previously reported by DBS target localization studies dealing with the subthalamic and thalamic nuclei. Our approach is advantageous in that it provides criteria to determine the DBS target without the need to rely on a patient's response while avoiding capsular effects.